| NPI | 1356884712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMY AMILCA Rcm Manager 772-248-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2025-08-29 |